C.R.S.
Section 26-5-104
Funding of child welfare services provider contracts
- funding mechanism review
- fund
- report
- rules
- definitions
- repeal
(1)
Reimbursement.(a)
Except as provided in subsection (1)(b) of this section, the state department shall, within the limits of available appropriations, reimburse the county departments eighty percent of amounts expended by county departments for child welfare services, up to the amount of the county’s allocation as determined pursuant to the provisions of this section, except as otherwise authorized in accordance with the close-out process described in subsection (7) of this section.(b)
The state department shall reimburse the county departments ninety percent of the amounts expended by county departments for adoption and relative guardianship assistance. The adoption and relative guardianship assistance is exempt from the close-out process described in subsection (7) of this section and the capped allocation described in subsection (3) of this section.(c)
On or before December 15, the delivery of child welfare services task force, established pursuant to section 26-5-105.8, shall make recommendations concerning the provisions of section 26-5-105.8 (1)(b).(d)
In making its recommendations pursuant to subsection (1)(c) of this section, the delivery of child welfare services task force shall consider:(I)
The impact of the institute for mental disease designation on qualified residential treatment programs for residential child care facilities; and(II)
The capacity of existing child welfare services, including placement availability, mental and behavioral health services, prevention services through the federal “Family First Prevention Services Act”, and other prevention services.(e)
The state department shall submit a report to the joint budget committee on or before January 15, 2021. The report must include the recommendations required pursuant to subsection (1)(c) of this section.(2)
Parental fees.(3)
Allocation formula.(a)
Intentionally left blank —Ed.(I)
For state fiscal year 2018-19 through state fiscal year 2023-24, the state department, after input from the child welfare allocations committee, shall develop formulas for capped and targeted allocations, including the child welfare services allocation, the allocation for additional county child welfare staff, and the allocation for family and children’s programs. Allocation formulas developed pursuant to this subsection (3)(a) must include, for each state fiscal year 2018-19 through 2023-24, the estimated caseload for the delivery of those specific child welfare services to be funded by the money in the capped or targeted allocations. The formulas must also include a performance-aligned component that supports the implementation and delivery of promising, supported, or well-supported practices, as defined in the federal “Family First Prevention Services Act of 2018”, as defined in section 26-5-101 (4.5); be outcome-driven; and be aligned with state-department-defined or federally required outcomes and goals. The allocation to each county from any given formula must be equitable and reflective of the cost of delivering services. If a county receives more than one capped or targeted allocation for the delivery of child welfare services, the formula must identify the specific caseload estimate attributable to each capped or targeted allocation.(II)
This subsection (3)(a) is repealed, effective July 1, 2024.(a.2)
Intentionally left blank —Ed.(I)
For state fiscal year 2024-25, and for each state fiscal year thereafter, the state department, after input from the child welfare allocations committee, shall use the funding model described in section 26-5-103.7 to determine the funding required for each county for adoption and relative guardianship subsidies and the independent living program, and to determine the capped and targeted allocations to each county, or group of counties, for child welfare services, additional county child welfare staff, and family and children’s programs.(II)
The state department, after input from the child welfare allocations committee, shall make the capped and targeted allocations described in subsection (3)(a.2)(I) of this section based on the total amount identified in the funding model as the appropriate level of funding required for each county to fully meet all state and federal requirements concerning the comprehensive delivery of child welfare services, as defined in section 26-5-101 (3), and prevention programs, as defined in section 19-1-103, less the amount appropriated by the general assembly in the annual long appropriations bill for adoption and relative guardianship subsidies and the independent living program. The allocations must be equitable and reflective of the cost of delivering services and must identify the specific caseload estimate attributable to each capped or targeted allocation.(III)
If the appropriation made for a fiscal year is not equal to the amount necessary to fully fund the allocations required by the funding model, the child welfare allocations committee shall make recommendations to the state department concerning how to modify the results of the funding model to align with the appropriation. After input from the child welfare allocations committee, the state department shall adjust the allocation to each county to ensure that the funding made available to all counties through capped and targeted allocations does not exceed the annual appropriation.(a.5)
Pursuant to this subsection (3), a county that receives an allocation for county child welfare staff in addition to the child welfare services allocation shall fund existing staff positions as of January 1, 2015, through the child welfare services allocation. Positions created after January 1, 2015, may be funded through the allocation for county child welfare staff.(a.6)
On or before March 1 of any state fiscal year, the child welfare allocations committee shall submit written recommendations to the state department to inform the capped and targeted allocations.(b)
In the event that the state department and the child welfare allocations committee do not reach an agreement on the allocation formula on or before June 1 of any state fiscal year for the succeeding state fiscal year, the state department and the child welfare allocations committee shall submit alternatives to the joint budget committee of the general assembly from which such joint budget committee shall select an allocation formula before the beginning of such succeeding state fiscal year.(c)
The formulas developed pursuant to this subsection (3) must identify the portion of the amounts appropriated for child welfare services that must be allocated to the counties for the provision of child welfare services.(d)
A county’s election to make a transfer of federal funds pursuant to section 26-2-714 (9) for the provision of child welfare services shall not be the basis of an adjustment to the formula for developing such county’s capped or targeted allocation under the provisions of this article.(e)
A county’s cost savings shall not be the basis of an adjustment to the formula for developing such county’s capped or targeted allocation under the provisions of this article.(4)
Allocations.(a)
For state fiscal year 1997-98, and for each state fiscal year thereafter, all counties shall receive capped allocations for child welfare services. A county may receive one or more capped allocations for the provision of child welfare services. The counties may use capped allocation moneys for child welfare services without category restriction within a specific capped allocation if not prohibited by federal law.(b)
Intentionally left blank —Ed.(I)
The state department shall make capped allocations for counties serving at least eighty percent of the total child welfare services population.(II)
For the balance of the state, the state department shall create one capped allocation or a series of capped allocations for the provision of child welfare services in the balance of the state. The state department shall establish a targeted allocation for each county in such group of counties designated for the purpose of such capped allocation or capped allocations.(c)
The state department, in consultation with the child welfare allocations committee, shall adopt rules for when a county may exceed its capped or targeted allocation or allocations.(d)
Except as provided for in subsections (4)(e) and (4)(f) of this section, the state department may only seek additional funding from the general assembly in a supplemental appropriations bill based upon caseload growth, subject to the provisions of subsection (7) of this section, or changes in federal law or federal funding.(d.5)
Intentionally left blank —Ed.(I)
For fiscal years 2018-19 through 2023-24, in addition to funding received pursuant to subsection (4)(d) of this section, the state department may seek additional funding from the general assembly in a supplemental bill related to the implementation of subsection (6) of this section, and subject to the provisions of subsection (7) of this section or changes in federal law or federal funding.(II)
This subsection (4)(d.5) is repealed, effective July 1, 2024.(e)
A county’s allocation or allocations may be amended due to caseload growth, subject to the provisions of subsection (7) of this section, or changes in federal law or federal funding.(f)
In addition to funding received pursuant to subsection (4)(d) of this section, the state department may submit a request to the general assembly for a change in a supplemental appropriations bill to the appropriation that funds adoption and relative guardianship assistance expenditures.(5)
Management training.(6)
County negotiations with providers.(a)
Subject to rules promulgated by the state department pursuant to subsection (6)(b) of this section and the methodology adopted pursuant to subsections (6)(e) to (6)(h) of this section, for each child or youth placed in an out-of-home placement setting, a county is authorized to negotiate rates related to services and outcomes with licensed out-of-home placement providers; except that a county may not negotiate rates below the base anchor rates established by the state department. A county is authorized to negotiate rates above the base anchor rates established by the state department with licensed out-of-home placement providers serving children in higher acuity cases.(b)
On or before January 1, 2019, and as necessary thereafter, the state department shall work collaboratively with the state board of human services to promulgate rules governing the methodology by which counties may negotiate rates, services, and outcomes with licensed out-of-home placement providers. If a county negotiates a contract with a licensed out-of-home placement provider, the county may define the expected outcomes and include options for the payment of incentives to providers when such outcomes are achieved. The state department shall work collaboratively with the state board of human services to promulgate rules concerning such outcomes and incentive payments.(e)
On or before September 29, 2017, as a continuation of the review conducted pursuant to subsection (6)(d) of this section of the methodology by which counties evaluate and negotiate rates, services, and outcomes with licensed out-of-home placement providers, the state department shall contract with an independent vendor to:(I)
Perform a salary survey related to the delivery of child welfare services. When possible, the entity must not duplicate existing efforts that collect public employee salary information but must instead incorporate existing information into the overall analysis. The survey must inform the development of the rate-setting methodology pursuant to subsection (6)(e)(III) of this section and must account for the functions, responsibilities, qualifications, and other relevant information for each position. The study must also guarantee that available information is gathered from a diverse range of geographical locations throughout Colorado, including urban, suburban, rural, and mountain resort communities. The study must include information pertaining to federal and state regulations or licensing requirements for each position. The study must also include salary surveys that represent employees performing all facets of similar work, utilizing similar knowledge, skills, and abilities for:(A)
Licensed out-of-home placement providers who have a contract with the state department or a county;(B)
Child placement agency employees;(C)
Residential child care facility employees; and(D)
County employees involved with the provision of child welfare services.(II)
Perform an actuarial analysis of the costs necessary to provide services at a level required by state statute, departmental rule, or federal rules and regulations, as appropriate for the families referred, including salary comparisons between licensed out-of-home placement provider categories and overhead and administrative costs, and determine the extent to which the salary survey identified in subsection (6)(e)(I) of this section should inform the actuarial analysis. The analysis must inform the development of the rate-setting methodology pursuant to subsection (6)(e)(III) of this section and must also guarantee that available information is gathered from a diverse range of geographical locations throughout Colorado, including urban, suburban, rural, and mountain resort communities.(III)
Develop the rate-setting methodology for licensed out-of-home placement provider compensation. The independent vendor shall solicit input from representatives from the state department, counties, the licensed out-of-home placement provider community, and the department of health care policy and financing. The methodology must be based on equal representation by counties and licensed out-of home placement providers.(f)
On or before April 2, 2018, the state department shall provide the joint budget committee with a report defining the rate-setting methodology developed pursuant to subsection (6)(e)(III) of this section, including the process through which the daily rate was determined.(g)
Intentionally left blank —Ed.(I)
Subject to available appropriations, the methodology must be implemented on or before July 1, 2018, except for those rates that must be approved by CMS. Rates that must be approved by CMS must be implemented upon approval. In the event that the representatives identified in subsection (6)(e) of this section do not agree on the rate-setting methodology on or before February 1, 2018, the state department, the county representatives, and the licensed out-of-home placement providers shall submit alternatives to the joint budget committee. The joint budget committee shall then select a methodology prior to the start of the succeeding state fiscal year. It is the intent of the general assembly that the rate methodology developed pursuant to this subsection (6) be fully implemented on or before June 30, 2022, through incremental rate increases established by the state department. For fiscal year 2019-20 through fiscal year 2021-22, the state department is encouraged to submit, as a part of the annual budget process, a request for increased appropriations to fund the increased rates required by the methodology.(II)
Intentionally left blank —Ed.(A)
Except for those rates that must be approved by CMS, on or before September 30, 2021, the state department shall fully implement adjusted rates for licensed out-of-home placement providers using the existing rate methodology established pursuant to subsection (6)(g)(I) of this section. The state department shall implement rates that must be approved by CMS upon approval by CMS. The full implementation of the updated rate methodology adjustments must include rates for division of youth services out-of-home placement providers and for new out-of-home placement provider options required pursuant to the federal “Family First Prevention Services Act of 2018”, as defined in section 26-5-101, and as informed by an updated actuarial analysis of the costs associated with such new provider options, with the exception of therapeutic foster care and treatment foster care, conducted pursuant to subsection (6)(g)(II)(B) of this section.(B)
For purposes of subsection (6)(g)(II)(A) of this section, the state department shall contract with an independent vendor to update the actuarial analysis conducted pursuant to subsection (6)(e)(II) of this section to add an analysis of the costs necessary to provide services by division of youth services out-of-home placement providers and licensed out-of-home placement provider options included in the federal “Family First Prevention Services Act of 2018”, as defined in section 26-5-101, that are not included in the original actuarial analysis, with the exception of therapeutic foster care and treatment foster care. The vendor shall complete the updated actuarial analysis on or before September 1, 2021.(h)
The rate-setting methodology developed pursuant to subsection (6)(e)(III) of this section must clearly utilize the daily rate and include:(I)
A process through which provider rate adjustments, including any cost of living adjustments, that are approved by the general assembly must be factored into establishing the daily rate; and(II)
A process through which outcomes related to the stability and well-being of the child are factored into establishing the daily rate contract with a licensed out-of-home placement provider.(i)
Intentionally left blank —Ed.(I)
At the beginning of the 2022-23 fiscal year, and at the beginning of every third fiscal year thereafter, the state department shall contract with an independent vendor to conduct a new actuarial analysis of all provider rates for licensed out-of-home placement providers, including the division of youth services out-of-home placement providers, that analyzes the costs necessary to provide services at a level required by state statute, department rule, or federal rules and regulations, as appropriate for the child or youth. The vendor shall determine whether the salary survey performed pursuant to subsection (6)(e)(I) of this section is sufficient for the actuarial analysis required pursuant to this subsection (6)(i)(I) or whether to update the salary survey. The vendor shall complete the actuarial analysis by September 1, 2023, and by September 1 of each year in which an actuarial analysis is conducted pursuant to this subsection (6)(i)(I).(II)
The state department shall update the rate-setting methodology for licensed out-of-home placement providers, including the division of youth services out-of-home placement providers, to reflect the new actuarial analysis by July 1, 2024, and by July 1 of each fiscal year immediately following the fiscal year in which a new actuarial analysis results in adjusted rates.(III)
Subject to available appropriations, except for those rates that must be approved by CMS, the state department shall implement any adjusted rates required by the rate-setting methodology by July 1, 2024, and by July 1 of each fiscal year immediately following the fiscal year in which a new actuarial analysis results in adjusted rates. The updated rate-setting methodology may include tiered provider rates based on acuity.(IV)
The state department is encouraged to submit for consideration during the annual budget process a request for adjusted appropriations to fund the rates required by the updated methodology.(V)
The state department shall submit a report to the joint budget committee no later than December 30, 2022, and no later than December 30 of each year thereafter in which an actuarial analysis is conducted. The report must include a summary of the actuarial analysis and the resulting adjustments to the rate-setting methodology.(6.1)
Intentionally left blank —Ed.(a)
On or before September 1, 2018, and on or before September 1 of each fiscal year thereafter, the state department, with input from counties, shall submit to the joint budget committee a report including information on workload increases or decreases for the preceding calendar year and the costs associated with such changes. The state department is encouraged to include in the report data on the cost of serving children placed in the care of licensed out-of-home placement providers based on case acuity.(b)
Notwithstanding section 24-1-136, the reporting requirement in subsection (6.1)(a) of this section continues indefinitely.(c)
Repealed.(6.2)
As used in this section, unless the context otherwise requires:(a)
“Acuity” means the level of service needed by the child or family.(b)
“CMS” means the federal centers for medicare and medicaid services in the United States department of health and human services.(c)
“Licensed out-of-home placement provider” means a licensed residential child care facility, a child placement agency, a secure residential treatment center, a psychiatric residential treatment facility, a qualified residential treatment program, or therapeutic foster care, as defined in section 26-6-903.(d)
“Workload” means the number of child welfare child abuse and neglect hotline calls, referrals, assessments, open cases, out-of-home placements, in-home services, new adoptions, relative guardian assistance, and adoption subsidies being handled by a county department of human or social services.(6.5)
The state department shall analyze and evaluate expenditures as reported by child placement agencies each year and compare such expenditures to county expenditures for the provision of foster care services. The state department shall provide, at least on an annual basis, such analyses and comparisons to county departments and the joint budget committee.(6.6)
Intentionally left blank —Ed.(a)
Each county or region of counties, as determined by the state department, shall, with assistance from the state department, perform an analysis of available in-home, family-like, and out-of-home placement settings. On or before July 1, 2019, each designated county or region of counties shall submit a report to the state department, including an evaluation of the types and availability of each placement option in the county or region of counties, available placement options in adjacent counties or region of counties, and a plan to expand in-home, family-like, and out-of-home placement settings capacity within the county or region of counties, if necessary.(b)
On or before July 1, 2020, the state department shall submit a report to the joint budget committee. The report must include:(I)
The county utilization rate for in-home, family-like, and out-of-home placement settings;(II)
An analysis of projected federal reimbursement for each type of placement pursuant to the federal “Family First Prevention Services Act of 2018”, as defined in section 26-5-101 (4.5);(III)
A description of anticipated changes in federal reimbursement for each type of placement;(IV)
An analysis of statewide services and placement capacity, informed by the county reports required pursuant to subsection (6.6)(a) of this section;(V)
Projections for the statewide fiscal impact resulting from changes in federal reimbursement; and(VI)
A plan to minimize the fiscal impact to the state resulting from changes in federal reimbursement for services and placement types.(c)
Repealed.(6.7)
Beginning in the state fiscal year 2021-22 and through state fiscal year 2022-23, the state department shall assist residential placement providers in the transition to a business model that ensures that out-of-home placements with the provider are eligible for reimbursement under Title IV-E of the federal “Social Security Act”, as amended, and ensures that a medicaid-eligible child or youth placed with the provider maintains eligibility for enrollment in the state’s medical assistance program. Assistance provided by the state department includes grants from not less than fifteen percent of the funding received from the federal “Family First Transition and Support Act of 2019”. The state department shall make grants available to providers no later than September 1, 2021, and shall continue to make grants available and award grants until January 1, 2023. Federal funding that has not been awarded as grants to providers by January 1, 2023, must be used for other purposes related to the implementation of the federal “Family First Prevention Services Act of 2018”.(7)
Close-out process for county allocations.(a)
Intentionally left blank —Ed.(I)
There is created in the state treasury the child welfare prevention and intervention services cash fund, referred to in this subsection (7) as the “fund”. The following two special accounts are created in the fund:(A)
The small- and medium-sized counties account, referred to in this subsection (7) as the “small- and medium-sized account”; and(B)
The all-counties account, referred to in this subsection (7) as the “all-counties account”.(II)
The state department is authorized to accept gifts, grants, and donations, which must be transferred to the fund and credited to the all-counties account within the fund.(III)
In addition to transfers credited to the all-counties account within the fund pursuant to subsection (7)(a.6) of this section, the general assembly may directly appropriate general fund money to the fund. If the general assembly makes a direct appropriation of general fund money to the fund, the money must be credited to the all-counties account within the fund. The state department, in consultation with the counties, shall determine the allocation of any money credited to the all-counties account within the fund, which money may be allocated to all counties, regardless of size.(IV)
The state department, in consultation with counties, shall allocate all money from the fund to increase local child welfare prevention and intervention services capacity, which allocations must be used by a county for the delivery of child welfare prevention and intervention services that have been approved by the state department.(V)
The state department shall work collaboratively with the state board of human services to promulgate rules concerning the allocation and use of money from the fund.(a.3)
Intentionally left blank —Ed.(I)
For state fiscal year 2018-19, and for each state fiscal year thereafter, except for state fiscal years 2019-20, 2020-21, and 2021-22, the state department retains any unspent general fund money included in the initial allocation to each balance of state county, up to five percent of the total general fund money allocated to balance of state counties, as described in subsection (4)(b) of this section and referred to in this subsection (7) as “small- and medium-sized counties”.(II)
Retained money pursuant to subsection (7)(a.3)(I) of this section must be transferred into the fund and credited to the small- and medium-sized account within the fund.(III)
Money from the small- and medium-sized account within the fund must be allocated by the state department, in consultation with small- and medium-sized counties, to small- and medium-sized counties to increase local child welfare prevention and intervention services capacity and must be used by counties for the delivery of child welfare prevention and intervention services that have been approved by the state department.(a.5)
Subject to the limitations set forth in this subsection (7), the state department may, at the end of a state fiscal year based upon the recommendations of the child welfare allocations committee, allocate any unexpended capped money for the delivery of specific child welfare services to any one or more counties whose spending has exceeded a capped allocation for such specific child welfare services.(a.6)
Subsequent to the allocation of any unexpended capped money pursuant to subsection (7)(a.5) of this section, and except for state fiscal years 2019-20, 2020-21, and 2021-22, any remaining state general fund money must be transferred to the fund and credited to the all-counties account within the fund for allocation by the state department to counties for the delivery of state-department-approved child welfare prevention and intervention services.(b)
A county may only receive money pursuant to subsection (7)(a.5) of this section for expenditures other than those attributable to administrative and support functions as referred to in section 26-5-101 (3)(m) and for authorized expenditures attributable to caseload increases beyond the caseload estimate established pursuant to subsection (3) of this section for a specific capped allocation.(c)
A county may not receive money pursuant to the provisions of subsection (7)(a.5) of this section for authorized expenditures attributable to caseload increases for services in one capped allocation from unexpended capped money in another capped allocation.(d)
As used in this section, “unexpended capped money” means money that has been appropriated for child welfare services, allocated to a county or group of counties as a capped allocation or allocations pursuant to the provisions of subsection (4) of this section.(7.5)
High-acuity treatment and services cash fund.(a)
There is created in the state treasury the high-acuity treatment and services cash fund, referred to in this subsection (7.5) as the “high-acuity cash fund”.(b)
The state department shall retain any unspent money appropriated in fiscal year 2022-23 and 2023-24 from the general fund for counties during the initial allocations for the administration of child welfare services, core services, or child welfare staffing. Unspent general fund money includes money remaining after transfers to the prevention and intervention services cash fund created in subsection (7)(a)(I) of this section.(c)
On June 30, 2023, and June 30, 2024, the state treasurer shall transfer any money retained pursuant to subsection (7.5)(b) of this section to the high-acuity cash fund. The money transferred pursuant to this subsection (7.5)(c) is available for expenditure through June 30, 2025.(d)
Intentionally left blank —Ed.(I)
The state department shall expend money from the high-acuity cash fund to provide additional resources to licensed providers to help remove barriers that providers face in serving children and youth whose behavioral or mental health needs require services and treatment that exceed capacity of the established daily rates, including for the same purposes identified in section 26-5-117 (2).(II)
Any licensed provider who receives money pursuant to subsection (7)(d)(I) shall meet the requirements of a qualified residential treatment program, as defined in section 26-5.4-102, a psychiatric residential treatment facility, as defined in section 25.5-4-103 (19.5), or therapeutic foster care, as defined in section 26-6-903 (35).(e)
This subsection (7.5) is repealed, effective July 1, 2025. Any money remaining in the high-acuity cash fund at the end of the 2024-25 fiscal year reverts to the general fund.(8)
County-level child welfare staff.(a)
For the state fiscal year 2015-16, and for each state fiscal year thereafter, each county may receive a capped allocation in addition to its portion of the child welfare block grant for the specific purpose of hiring new child welfare staff at the county level in addition to child welfare staff existing as of January 1, 2015. A county that utilizes said additional allocation shall continue to pay for child welfare staff positions existing as of January 1, 2015, through the child welfare block grant.(b)
Each county that receives an allocation for child welfare staff pursuant to paragraph (a) of this subsection (8) shall provide a ten percent match to state and federal moneys provided pursuant to this subsection (8); except that a county that qualifies as tier 1 or tier 2 for purposes of the county tax base relief fund, as defined in section 26-1-126 (3) and (4), is funded at one hundred percent of state and federal funds provided pursuant to this subsection (8).(c)
Any moneys allocated pursuant to this subsection (8) that are not expended by the end of a fiscal year for the purpose specified in paragraph (a) of this subsection (8) must revert back to the general fund.(9)
Repealed.
Source:
Section 26-5-104 — Funding of child welfare services provider contracts - funding mechanism review - fund - report - rules - definitions - repeal, https://leg.colorado.gov/sites/default/files/images/olls/crs2023-title-26.pdf (accessed Oct. 20, 2023).
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